• Johannes Doescher, Kathrin Scheckenbach, Wolfgang Angerstein, Johannes A Veit, Simon Laban, Julia Thierauf, Marie-Nicole Theodoraki, Jens Greve, Patrick J Schuler, and Thomas K Hoffmann.
• Department of Otorhinolaryngology, Head and Neck Surgery, Ulm University Medical Center, Ulm, Germany.
• Ann Oto Rhinol Laryn. 2016 Feb 1; 125 (2): 145-50.

BackgroundAfter laryngectomy, the tracheostoma forms the functional center for breathing and phonation. An occasionally occurring but typical problem can arise from an oversized and/or irregularly formed tracheostoma, hampering the temporary occlusion necessary for sufficient speech production. As an alternative to a surgical correction of the tracheostoma, an individually adjusted stoma silicone prosthesis may be used.Materials And MethodsTwenty-one patients suffering from irregularly formed tracheostoma after laryngectomy followed by insertion of a speech valve were provided with a silicone tracheostomal prosthesis. They underwent subjective assessment of voice quality and breathing function according to a standardized general questionnaire and to the Voice Handicap Index (VHI). Furthermore, a clinical evaluation was performed including detection of peristomal leakage and phonation time.Results And DiscussionPatients described a significant improvement of voice production with the tracheostomal prosthesis (averagely graded as 1.9 with and 3.2 without prosthesis, P = .0026). Breathing was also slightly improved by the prosthesis with an average grade of 1.7 compared to 2.3 with a conventional cannula (P = .063). There was a strong correlation between self-evaluation and the total score of the VHI after insertion of the prosthesis (P < .0001). Minor local skin reactions caused by the adhesive were described by 5 of the 21 patients.ConclusionsA tracheostomal prosthesis represents an efficient alternative to surgical revision of irregularly formed tracheostoma after laryngectomy, enhancing voice production and breathing function.© The Author(s) 2015.

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